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Reduction of opioid use and improvement in chronic pain in opioid-experienced patients after topical analgesic treatment: an exploratory analysis.

Abstract There is a need to identify safe and effective opioid-sparing multimodal alternative treatment strategies and approaches, including topical analgesics, for opioid-experienced chronic pain patients to mitigate the risk of addiction, misuse, and abuse of opioids.
PMID
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Changes in pain and concurrent pain medication use following compounded topical analgesic treatment for chronic pain: 3- and 6-month follow-up results from the prospective, observational Optimizing Patient Experience and Response to Topical Analgesics study.

Authors

Mayor MeshTerms
Keywords

Chronic pain

opioid epidemic

opioid-experienced

opioids

pain interference

pain severity

topical analgesics

Journal Title postgraduate medicine
Publication Year Start




PMID- 29224410
OWN - NLM
STAT- MEDLINE
DCOM- 20180103
LR  - 20180103
IS  - 1941-9260 (Electronic)
IS  - 0032-5481 (Linking)
VI  - 130
IP  - 1
DP  - 2018 Jan
TI  - Reduction of opioid use and improvement in chronic pain in opioid-experienced
      patients after topical analgesic treatment: an exploratory analysis.
PG  - 42-51
LID - 10.1080/00325481.2018.1414551 [doi]
AB  - OBJECTIVE: There is a need to identify safe and effective opioid-sparing
      multimodal alternative treatment strategies and approaches, including topical
      analgesics, for opioid-experienced chronic pain patients to mitigate the risk of 
      addiction, misuse, and abuse of opioids. METHODS: This subset analysis from a
      prospective, observational study evaluated changes in opioid use, other
      concurrent medication use, and pain severity and interference in
      opioid-experienced patients (OEP) treated with topical analgesics for chronic
      pain with measures obtained at baseline and 3- and 6- month follow-up. RESULTS:
      The 3-month opioid-experienced patient (3-month OEP) group included 121 patients 
      who completed baseline and 3-month follow-up assessments; 27 opioid-experienced
      patients completed baseline and 6-month follow-up assessments (6-month OEP).
      Demographic characteristics, and mean pain severity and interference scores were 
      similar between groups at baseline. After treatment with topical analgesics, 49% 
      of patients in the 3-month and 56% of patients in the 6-month group reported they
      had completely discontinued use of opioids. In addition, 31% of patients at the
      3-month assessment and 30% at the 6-month assessment reported that they were no
      longer taking any pain medication. Other concurrent medications decreased by 65% 
      after 3 months, and 74% after 6 months. There were statistically significant
      decreases from baseline in pain severity and interference scores within the 3-
      (CI:0.7-1.4, 1.4-2.2) and 6-month (CI:0.7-2.4 (severity); CI:1.2-3.5
      (interference)) OEP groups. CONCLUSIONS: Opioid use and other concurrent
      medications decreased among opioid-experienced chronic pain patients after 3- and
      6- months of treatment with topical analgesics. Pain severity and interference
      scores also decreased. The topical analgesics were reported to be effective and
      safe for the treatment of chronic pain, with randomized controlled trials needed 
      to confirm these findings.
FAU - Gudin, Jeffrey A
AU  - Gudin JA
AD  - a Englewood Hospital and Medical Center , Englewood , NJ , USA.
FAU - Brennan, Michael J
AU  - Brennan MJ
AD  - b The Pain Center of Fairfield , Fairfield , CT , USA.
FAU - Harris, E Dennis
AU  - Harris ED
AD  - c Clarity Science , Austin , TX , USA.
FAU - Hurwitz, Peter L
AU  - Hurwitz PL
AD  - c Clarity Science , Austin , TX , USA.
FAU - Dietze, Derek T
AU  - Dietze DT
AD  - d Metrics for Learning , LLC , Queen Creek , AZ , USA.
FAU - Strader, James D
AU  - Strader JD
AD  - e Safe Harbor Compliance and Clinical Services , LLC , Austin , TX , USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Postgrad Med
JT  - Postgraduate medicine
JID - 0401147
RN  - 0 (Analgesics, Opioid)
SB  - AIM
SB  - IM
MH  - Administration, Topical
MH  - Adolescent
MH  - Adult
MH  - Analgesics, Opioid/*therapeutic use
MH  - Chronic Pain/diagnosis/*drug therapy/etiology
MH  - Combined Modality Therapy
MH  - Drug Administration Schedule
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Opioid-Related Disorders/*prevention & control
MH  - Pain Measurement
MH  - Patient Satisfaction
MH  - Prospective Studies
MH  - Self Report
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Chronic pain
OT  - opioid epidemic
OT  - opioid-experienced
OT  - opioids
OT  - pain interference
OT  - pain severity
OT  - topical analgesics
EDAT- 2017/12/12 06:00
MHDA- 2018/01/04 06:00
CRDT- 2017/12/12 06:00
PHST- 2017/12/12 06:00 [pubmed]
PHST- 2018/01/04 06:00 [medline]
PHST- 2017/12/12 06:00 [entrez]
AID - 10.1080/00325481.2018.1414551 [doi]
PST - ppublish
SO  - Postgrad Med. 2018 Jan;130(1):42-51. doi: 10.1080/00325481.2018.1414551.